Levels of processing with free and cued recall and unilateral temporal lobe epilepsy

This study investigates the role of the temporal lobes in levels-of-processing tasks (phonetic and semantic encoding) according to the nature of recall tasks (free and cued recall). These tasks were administered to 48 patients with unilateral temporal epilepsy (right "RTLE"=24; left "LTLE"=24) and a normal group (n=24). The results indicated that LTLE patients were impaired for semantic processing (free and cued recall) and for phonetic processing (free and cued recall), while for RTLE patients deficits appeared in free recall with semantic processing. It is suggested that the left temporal lobe is involved in all aspects of verbal memory, and that the right temporal lobe is specialized in semantic processing. Moreover, our data seem to indicate that RTLE patients present a retrieval processing impairment (semantic condition), whereas the LTLE group is characterized by encoding difficulties in the phonetic and semantic condition.     

Remembering versus knowing during face recognition in unilateral temporal lobe epilepsy patients with or without hippocampal sclerosis

Recognition memory involves knowing an item was learned (familiarity) and remembering contextual details about the prior learning episode (recollection). We tested three competing hypotheses about the role of the hippocampus in recollection and familiarity. It mediates either recollection or familiarity, or serves both processes. We further tested whether the left temporal lobe mediates recollection and the right temporal lobe familiarity (modes of processing view), or whether the two temporal lobes mediate remembering material specifically (material specificity view). We investigated 24-h face recognition using the "remember-know" procedure. We studied 23 left and 24 right temporal lobe epilepsy (LTLE/RTLE) patients with and without hippocampal sclerosis (HS+/HS-) and 31 healthy participants. HS+ patients made fewer know responses than HS- patients or healthy participants. RTLE was related to fewer remember responses than LTLE. Our results suggest the hippocampus has a critical role in familiarity. Further, our findings support the material specificity hypothesis of laterality.     

Verbal Fluency in Focal Epilepsy: A Systematic Review and Meta-analysis

Testing of verbal fluency is currently part of standard presurgical neuropsychological assessment for patients with focal epilepsy. However, to date no systematic review has been conducted on semantic (SVF) and phonemic verbal fluency (PVF) in this patient group. The present review compares verbal fluency between healthy control subjects and subgroups of adult presurgical patients with focal epilepsy according to lateralisation and localisation of the dysfunction. PubMed was searched with a comprehensive search string. Abstracts of all studies and full-texts of potentially relevant studies were screened. Study quality was assessed by independent raters according to predefined criteria. 39 studies were included. Meta-analyses were performed to compare SVF and PVF across groups of patients with temporal (TLE) and frontal lobe epilepsy (FLE) as well as healthy controls (HC). Both patients with left- and right sided TLE were impaired on SVF and PVF compared to HC. Patients with left-sided TLE were slightly more impaired than patients with right-sided TLE. Patients with FLE showed a larger impairment in PVF than patients with TLE, whereas on SVF there was no difference between FLE and TLE. For TLE comparisons the study pool seems to have been sufficient, whereas more studies are needed to verify results for FLE. Semantic verbal fluency might not differentiate between FLE and TLE. While verbal fluency impairment was anticipated, especially in left-sided TLE and FLE patients, the impairment in patients with right-sided TLE was larger than expected. Results are discussed with regard to neuropsychological theory and practice.     

Dreaming and cognition in patients with frontotemporal dysfunction

Individuals with Parkinson’s disease (PD) and temporal lobe epilepsy (TLE) have hallucinations and mild cognitive dysfunction. The objective of this work was to study dreams in PD and TLE patients using a common functional model of dream production involving the limbic and paralimbic structures.Dreams were characterised in early-stage PD (19 males) and TLE patients (52) with dream diaries classified by the Hall van de Castle system and were compared with matched controls.In PD, there were significant differences between patients’ dreams and those of controls: animals, physical aggression, and a befriender were more common in patients, and aggressor and bodily misfortunes were less common. The dreams of patients with frontal dysfunction showed more aggressive features.TLE patients had lower recall than PD patients and a higher proportion of dreams involving family and familiar settings, lower proportions involving success, and a higher incidence of frontal dysfunction.The dreams of PD and TLE patients share important features.     

Dissociation of short- and long-term face memory: evidence from long-term recency effects in temporal lobe epilepsy

We tested whether memory deficits in temporal lobe epilepsy (TLE) are better described by a single- or dual-store memory model. To this aim, we analyzed the influence of TLE and proactive interference (PI) on immediate and 24-h long-term recency effects during face recognition in 16 healthy participants and 18 right and 21 left non-surgical TLE patients. PI in healthy participants or TLE erased the long-term recency effect, but left the immediate recency effect unaffected. Although the immediate recency effect was still visible in right TLE patients, the number of detected recency items during immediate recognition was decreased in right TLE compared to left TLE. Right TLE was also related to decreased detection of pre-recency items during delayed recognition compared to left TLE, and decreased detection of pre-recency items during immediate recognition under PI. The results show that the temporal lobes are necessary for the long-term recency effect, but not for the immediate recency effect, and thus speak for a dissociation of short- and long-term memory for faces. Right TLE is related to more severe long-term memory deficits than left TLE and is also related to additional short-term memory deficits for faces.     

Attentional control in patients with temporal lobe epilepsy

Across different studies, patients with temporal lobe epilepsy (TLE) demonstrate impairments on numerous measures of attentional control that are classically associated with frontal lobe functioning. One aspect of attentional control that has not been examined in TLE is the ability to execute two modality‐specific tasks concurrently. We sought to examine the status of dual‐task coordination in TLE. We further examined the cohorts' performance on a range of traditional measures of attentional control. Eighteen TLE patients and 22 healthy controls participated in the study. Dual‐task performance involved comparing the capacity to execute a tracking and a digit recall task simultaneously with the capacity to execute the tasks separately. We also administered measures of: set shifting (odd‐man‐out test), sustained attention (elevator counting), selective attention (elevator counting with distraction), and divided attention (trail making test). We found that the proportional decrement in dual‐task performance relative to single‐task performance did not vary between the groups (TLE = 92.48%; controls = 93.70%), nor was there a significant difference in sustained attention (p > .10). Patients with TLE did demonstrate marked deficits in selective attention (p < .0001), divided attention (p < .01), and set shifting (p < .01). These findings add to the knowledge about cognitive dysfunction in TLE, indicating that impairments in attentional control in TLE tend to be selective. The greatest deficits appear to be on tasks that invoke a high level of processing resources. In contrast, sustained attention is less compromised and the capacity to allocate cognitive resources appears to be normal in patients with TLE.     

The direct measurement of hypothesis-sampling strategies

The concept-identification (CI) literature supports a hypothesis-sampling theory. Hypotheses based on attributes, sample sizes greater than one, and nonreplacement of eliminated hypotheses all occur. An experimental procedure was developed to measure hypothesis-sampling directly where the subject is allowed to select attributes that he wishes to see, then randomly selected values on the selected attributes are presented.Generally, the average sample size before the trial of the last error (TLE) does not change but does change after TLE. The probabilities of eliminating inconsistent hypotheses and keeping consistent hypotheses increase over problems. The proportion of eliminated attributes which are resampled decreases over problems. Individual subjects are extremely varied in sample size, efficiency measures, and resampling tendencies. The rate of solution, TLE, is related to the efficiency and resampling measures but not to the sample size.     

Dissociations among memory measures in memory-impaired subjects: Evidence for a processing account of memory

Deficits in conceptual transfer on both implicit and explicit memory tests were obtained for memory-impaired temporal lobe epileptic (TLE) subjects in three studies. In Experiment 1, in which a generate-read paradigm was employed, memory-impaired TLEs failed to show normal generation effects on conceptually driven tests of semantic cued recall and general knowledge questions, although their data-driven memory as measured by word-fragment completion and graphemic cued recall tasks was normal. In Experiment 2, memory-impaired patients having left temporal lobe seizure foci were tested on these four tasks and compared with nonimpaired TLEs having right temporal foci. The left TLEs showed deficits on conceptually driven tasks and normal memory for data-driven tests. These findings were extended in Experiment 3, in which left TLE patients failed to show any benefit from blocked study, as compared with random study, on category production and semantic cued-recall tests, although right TLEs and normal controls showed blocking effects on both tasks. These findings may be accommodated by a processing framework of memory in which memory-impaired patients are characterized as having deficits in conceptual, but not in data-driven, processing capabilities.     

Ambiguous emotion recognition in temporal lobe epilepsy: The role of expression intensity

The lateralization of emotion processing is currently debated and may be further explored by examining facial expression recognition (FER) impairments in temporal lobe epilepsy (TLE). Furthermore, there is also debate in the literature whether FER deficits in individuals with TLE are more pronounced in the right than in the left hemisphere. Individuals with TLE were tested with an FER task designed to be more sensitive than those classically used to shed light on this issue. A total of 25 right- and 32 left-TLE patients, candidates for surgery, along with controls, underwent an FER task composed of stimuli shown not only at full-blown intensities (100 %), but also morphed to lower-intensity display levels (35 %, 50 %, and 75 %). The results showed that, as compared to controls, right-TLE patients showed deficits in the recognition of all emotional categories. Furthermore, when considering valence, right-TLE patients were impaired only in negative emotion recognition, but no deficits for positive emotions were highlighted in left-TLE patients. Finally, only the right-TLE patients’ impairment was found to be related to the age of epilepsy onset. Our work demonstrates that the FER deficits in TLE span multiple emotional categories and show manifestations dependent on the laterality of the epileptic focus. Taken together, our findings provide the strongest evidence for the right-hemisphere model, but they also partially support the valence model. We suggest that current models are not exhaustive at explaining emotional-processing cerebral control, and further that multistep models should be developed.     

Temporal lobe epilepsy and the selective reminding test: the conventional 30-minute delay suffices

Conventional memory assessment may fail to identify memory dysfunction characterized by intact recall for a relatively brief period but rapid forgetting thereafter. This study assessed learning and retention after 30-min and 24-hr delays on auditory and visual selective reminding tests (SRTs) in right (n=20) and left (n=22) temporal lobe epilepsy (TLE) patients and controls (n=49). The left TLE group performed significantly worse than controls on all 3 trials of both tests. The right TLE group differed from the controls on all 3 visual SRT trials and on learning for the auditory SRT. There were no between-groups differences in rate of information lost at the 30-min versus the 24-hr delay. At the individual level, there was no difference in the percentage of patients versus controls who demonstrated isolated memory impairment at the 24-hr delay. Accelerated forgetting over 24 hr is uncommon in TLE patients.     

Early and Late Life Exposure to Trauma and Biopsychosocial Well-Being in Centenarians

Few studies have investigated the proximal versus distal influence of traumatic life events (TLE) on biopsychosocial resources of very old adults. The Developmental Adaptation Model was used to test TLE experienced before and after the age of 60 on outcomes of centenarians’ physical disability, perceived health impairments, depressive symptoms, and social support. Cross-sectional data were collected from 154 community-dwelling centenarians. Results indicated that TLE in the latter half of life were positively associated with health impairments and depressive symptoms. The present results emphasize the importance of a process-oriented approach to resilience that allows flexibility in successful coping across the lifespan.     

The line copy task for kinesthesia and internal movement representation: application in children

In the present study a new test is proposed and tested, which requires ability to use information both from kinesthesia and from mental rotation of previously produced cyclic movements over a distinct trajectory. This Line Copy Test (LICT) was performed by 58 children aged 7-11 years. For the S-part, the participants first had to make movements till they reached a barrier and then they were required to reproduce the same (S) movements without the barrier. For the O-part of the test the participants had to rely on an internal representation of a felt trajectory length, and reproduce the movement orthogonal (O) to the ones felt. Trajectory Length Error (TLE) and variable error (VE) were measured. Furthermore, results of the LICT were correlated to the Kinesthetic Acuity Test and a pegboard task. The general finding was that the TLE, capturing the spatial calibration of the movement, and the VE, used as a measure of noise or inconsistency in the 10 reproductions, was largest for the youngest children, but this developmental effect was not significant in the O-part of the test. Although participants of all age groups made much larger TLE in the rotated task (O-part) than in the LICT_S-part, the VE was much smaller. This can be explained by assuming that different underlying control mechanisms underlie each task. Also differences in correlations of the two parts of the test with the other measures infer that they measure dissimilar underlying entities. It is likely that at least some portion of the increased movement variability in the S-part seen during development in young children can be attributed to partly unstable kinesthetic representations for hand movements. The finding that no significant development was found on the O-part indicates that changes in the use of internal models must occur outside the age window studied.     

Contributions of volumetrics of the hippocampus and thalamus to verbal memory in temporal lobe epilepsy patients

Recent theories have posited that the hippocampus and thalamus serve distinct, yet related, roles in episodic memory. Whereas the hippocampus has been implicated in long-term memory encoding and storage, the thalamus, as a whole, has been implicated in the selection of items for subsequent encoding and the use of retrieval strategies. However, dissociating the memory impairment that occurs following thalamic injury as distinguished from that following hippocampal injury has proven difficult. This study examined relationships between MRI volumetric measures of the hippocampus and thalamus and their contributions to prose and rote verbal memory functioning in 18 patients with intractable temporal lobe epilepsy (TLE). Results revealed that bilateral hippocampal and thalamic volume independently predicted delayed prose verbal memory functioning. However, bilateral hippocampal, but not thalamic, volume predicted delayed rote verbal memory functioning. Follow-up analyses indicated that bilateral thalamic volume independently predicted immediate prose, but not immediate rote, verbal recall, whereas bilateral hippocampal volume was not associated with any of these immediate memory measures. These findings underscore the cognitive significance of thalamic atrophy in chronic TLE, demonstrating that hippocampal and thalamic volume make quantitatively, and perhaps qualitatively, distinct contributions to episodic memory functioning in TLE patients. They are also consistent with theories proposing that the hippocampus supports long-term memory encoding and storage, whereas the thalamus is implicated in the executive aspects of episodic memory.     

Students’ achievement motivation in Finnish and Chinese higher education and its relation to perceived teaching-learning environments

This cross-cultural study of Finnish and Chinese students set out to compare the levels of achievement motivation (AM) in order to investigate whether the differences in them might be explained by the different cultural response styles and whether these response styles could be controlled for with a method which includes response style variables as covariates in ANCOVA. This study also scrutinizes relationships between perceived teaching-learning environments (TLE) and AM within each cultural group. The survey sample consisted of 3,035 Finnish and 2,309 mainland Chinese university students. Finnish students were found to rate the level of AM markedly higher than do Chinese students. It was determined that the method applied for response style controlling is not suitable for cross-cultural studies, even though it is recommended for this use. A modification of the method, which is based on robust statistical tools, was found not to change this conclusion, but it can nevertheless be used to obtain useful information about the effects of response style differences. The results also show that similar relationships between AM and TLE could be identified in the data of both groups. However, for the Finnish group AM is related to perceived suitable workload, whereas for the Chinese group it is related to teacher encouragement.     

Recent Innovative Studies of Memory in Temporal Lobe Epilepsy

Investigations of patients with temporal lobe epilepsy continue to result in significant advancements in the neuroscience of human memory, as they have for over 50 years. Recent reviews describing the state of the art in the clinical neuropsychology of TLE generally have emphasized (1) lateralization of cognitive deficits and the material-specific model of memory and/or (2) the relationships among pre- and post-surgery performance on standardized measures of anterograde memory, demographic and epilepsy variables and neuroimaging, neuropathology, and neurosurgery data. As information continues to accumulate about the pattern of performance on standard laboratory memory tests and the implications of these data before and after anterior temporal lobectomy for the treatment of TLE, innovative assessment techniques also are increasingly being applied. This review focuses on English language publications that addressed selected novel topics in adult TLE memory research. These topics are: (1) remote memory; (2) accelerated forgetting or long term amnesia; and (3) lateral versus mesial temporal lobe contributions to memory.     

Controlled recall of verbal material in temporal lobe epilepsy

This study used a guided process‐dissociation procedure to examine the contribution of controlled and automatic uses of memory to a cued‐recall task in 24 patients with unilateral temporal lobe epilepsy (TLE: 12 left‐sided; 12 right‐sided), and 12 neurotypical controls. In an inclusion task, participants attempted to complete three‐letter word stems using previously studied words, in an exclusion task they aimed to avoid using studied words to complete stems. Patients with left TLE produced fewer target completions under inclusion conditions. Completion rates were not significantly different under exclusion conditions. Estimates derived from process dissociation calculations, confirmed that the cued‐recall deficit in left TLE patients arose entirely from impairment in controlled memory processes. There were no group differences in the estimates of automatic processes. Recognition judgements of stems corresponding to studied words did not differ between the groups. Overall the results support the view that controlled and automatic memory processes are mediated by separable neural systems. Hippocampal and related structures within the left MTL are more important than corresponding right hemisphere structures for the controlled retrieval of verbal material. In contrast, the findings from this study do not suggest that the left and right temporal lobes make a differential contribution to automatic memory processing. The theoretical and clinical relevance of these findings are discussed.     

Neurology,psychology, and extraordinary religious experiences

Temporal lobe epilepsy and certain personality disorders often result in experiences described as religious. TLE research suggests a possible neurological basis for such experiences. Immediately the question arises about the authenticity of these experiences as religious. An experience is authentic if it furthers the authentic growth of the subject, regardless of what triggered it. So pathology may occasion authentic religious experiences, even as history exemplifies. For practical purposes, the further question about God in religious experience is secondary. The exception, miraculous occurrences, should not be granted without sufficient reason. This approach dissolves all conflict between science and faith.     

Running-wheel avoidance learning in rats (Rattus norvegicus): effects of contingencies and comparisons of different strains

In Experiment 1, we showed that active- and passive-avoidance responding in a running wheel was learned because of the avoidance contingency. In Experiment 2, strain differences among four commercially bred rats were assessed in an active-avoidance paradigm. Wistar, Donryu, and Fischer rats learned faster than Sprague-Dawleys. In Experiment 3, learning in a multiple active/passive avoidance schedule was examined, and both components of this task were learned. This multiple schedule was used to investigate strain differences in selectively bred rats in Experiments 4 and 5. Tsukuba low-emotional (TLE) rats responded more than Tsukuba high-emotional (THE) rats in both components. However, discrimination of passive components was better in THE than in TLE rats. Syracuse high-avoidance rats were superior in the active component, whereas Syracuse low-avoidance rats showed superior performance in the passive component.     

Do traumatic events influence the clinical expression of compulsive hoarding?

Traumatic experiences have been posited as one potential catalyst for the abrupt onset of obsessive-compulsive symptoms including compulsive hoarding. To determine whether traumatic life events (TLEs) might influence the expression of compulsive hoarding in obsessive-compulsive disorder (OCD), interview responses to the Posttraumatic Stress Disorder module of the Structured Clinical Interview for DSM-IV (SCID) were examined in 180 individuals with OCD. Compared to individuals with OCD who did not meet criteria for hoarding, participants classified as hoarders (24% of the sample) were significantly more likely to have reported at least one TLE in their lifetime. Patients who met criteria for hoarding and who had also experienced TLEs had significantly greater hoarding symptom severity than those hoarders not exposed to trauma. This association was found to be robust. That is, the relationship between TLEs and hoarding symptom severity was not better accounted for by age, age of OCD onset, depressive symptoms, general OCD symptomatology, or mood and anxiety comorbidity. Closer examination revealed that the clutter factor of compulsive hoarding (and not difficulty discarding or acquisitioning) was most strongly associated with having experienced a traumatic event.     

Lateralization of auditory rhythm length in temporal lobe lesions

In the visual modality, short rhythmic stimuli have been proven to be better processed (sequentially) by the left hemisphere, while longer rhythms appear to be better (holistically) processed by the right hemisphere. This study was set up to see if the same holds in the auditory modality. The rhythm task as originally designed by Seashore was computerized and is part of the Fepsy Neuropsychological battery. This task was performed by 85 patients with intractable temporal lobe epilepsy (left TLE = 32; right TLE = 53) enrolled in the Dutch Collaborative Epilepsy Surgery Program. They performed the task before and 6 months after surgery. The task consists of 30 pairs of rhythmic patterns in 3 series of 10 items. The series contains patterns of 5, 6, or 7 notes. The purpose is to indicate whether the two patterns are the same or different. Reaction times are also measured. If the hypothesis is true, the short-item sequence will be better processed by patients with right temporal lobe epilepsy (nonimpaired left temporal lobe), the longer sequence will be better processed by the left temporal epilepsy group (nonimpaired right temporal lobe). No overall laterality effect on rhythm perception could be found and no difference was found between both test moments. IQ did not correlate with rhythm performance. However, there was an interaction effect of laterality and rhythm length on performance and reaction time. This effect can be explained by the increase after the operation of the score of the left focus group and a decrease in the right focus group on the longer rhythms. This effect was somewhat less strong in the reaction times: a clear tendency for faster reaction times after surgery in the left and longer reaction times in the right focus group. The effect could not be explained for by the difference in extent of resection in either temporal lobe. This study showed that memory for and discrimination of auditory rhythm is dependent on which hemisphere is used in processing. The effect could be demonstrated for the right hemisphere, which uses a holistic processing of stimuli, which outperforms the left in rhythms consisting of a long sequence. In left temporal resections an improvement occurs on the longer rhythms and in right temporal resections the performance on the longest rhythms decreases.